What is the best initial treatment for venous stasis ulcers?
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The mainstay of initial treatment of venous stasis ulcers is compression therapy (strength of recommendation [SOR]: A, systematic review of randomized controlled trials [RCTs]). Multicomponent compression therapy is slightly superior to single-component therapy (SOR: B, systematic review of RCTs with inconsistent results). The various types of dressings available for managing venous stasis ulcers are similarly efficacious (SOR: A, systematic review of RCTs). Systemic therapies such as aspirin (SOR: B, single RCT) and pentoxifylline (SOR: A, systematic review of RCTs) improve healing rates whereas antibiotics don't (SOR: A, systematic review of RCTs). Cadexomer iodine, a topical antiseptic, improves ulcer healing but may not be feasible in most clinical settings because of the frequent dressing changes required (SOR: B, single RCT).
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